Antibiotic prophylaxis at triage for simple traumatic wounds

Abstract

Antibiotic administration at the time of wound manipulation has not been shown to decrease infection rates for simple traumatic wounds. Antibiotic administration at the time of initial emergency department (ED) presentation, however, has not been explored. Patients presenting to the ED with simple traumatic wounds received 1 g of oral flucloxacillin, or identical placebo, at triage. Wound closure was completed at the discretion of a physician blinded to study contents. Wound infection rates were determined at 1 month. Time from drug administration to wound manipulation was 64.3 min [95% confidence interval (CI) 36.6-91.9] placebo versus 75.0 min (95% CI: 51.7-98.3) flucloxacillin, P=0.657. Six of 36 patients (17%) reported wound infection in the placebo group, and four of 34 (12%) in the flucloxacillin group, P=0.736. Administration of oral flucloxacillin at triage failed to reduce the rate of wound infection for simple traumatic wounds closed in the ED.

Early prevention of trauma-related infection/sepsis

“…The administration of oral antibiotics is often applied to prevent wound infection for simple traumatic wounds [32, 33]. In addition, antibiotic ointments containing bacitracin, polymyxin, neomycin or cetrimide are often used in minor uncomplicated soft tissue wounds and have lower skin infection rates [34].…”